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Bird flu in Cambodia

Link to free book and poster downloads,

Avian Influenza A (H5N1), Cambodia

11 year old girl died of H5N1

Father tested positive for H5N1

Human-to-human transmission of H5N1, incredibly rare

Not impossible

Cambodia, 2003 to 2014

56 human cases of H5N1,

37 of them were fatal

From 2003 to 25 February 2023

873 human cases of infection with influenza A (H5N1)

458 deaths have been reported

From 21 countries.

Reported 23 February 2023

Cambodia International Health Regulations (IHR) National Focal Point (NFP)

Confirmed human infection with avian influenza A (H5N1)

A second case, family contact, reported 24 February 2023

First two cases of avian influenza A (H5N1) reported from Cambodia since 2014

December 2003 to 2014

All human cases due to poultry-to-human transmission

Description of the cases

Referred, 21 February 2023

Admitted to the National Pediatric Hospital with severe pneumonia

Tested positive for avian influenza A (H5N1) virus,

by reverse transcriptase-polymerase chain reaction (RT-PCR)

Institute Pasteur Cambodia, confirmed the finding

Died on 22 February 2023

Cambodia shared the genetic sequence data

Twelve close contacts tested

Father, asymptomatic, in isolation at the referral hospital

The eleven other samples tested negative for A (H5N1) and SARS-CoV-2.

Further human cases can be expected
WHO advice

PPE for infected poultry workers

Registered and monitored closely for seven days

Currently, no vaccine widely available to protect against avian influenza in humans.

WHO, poultry or birds workers, seasonal influenza vaccination, reduce risk of reassortment.

Cambodian CDC

Bird flu virus H5N1, cause of death, Rolang village, Khlach commune

There has not been any clear evidence of transmitting H5N1 bird flu from person to person.

Clade identified is (H5N1)

Circulating in poultry in southeast Asia since 2014



Clade viruses (H5N1)

Detected in birds, many countries in Africa, Asia, Europe, North America, Central and South America

The high levels of infection in birds, increased geographic distribution = genetic diversification


Droplet, bird saliva, nasal secretions

Flapping wings etc


Fomites and surfaces

Direct contact

Meat (virus killed by heat)

Into eyes, nose mouth

Avoid any contact with wild birds

H5N1 influenza A, history

First detected, chickens, Scotland, 1959

China and Hong Kong, 1996

First was detected in humans, 1997

Hong Kong, 1997, 18 H5N1 cases in Hong Kong,

some were acquired human-to-human

This outbreak

Infected 15 million domesticated birds

Countless wild birds and animals

Detected in foxes, otters, seals, mink

Therefore more opportunities to mutate

In the UK

All farmed chickens now required indoors


Very high levels of transmission in wild birds

Constant risk


10 billion animals killed for meat in the US in 2022

Imported 200 million live animals

Human infection possible at any stage in the meat supply chain

58 million birds culled

One US human case in 2022, recovered


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